scholarly journals The bactericidal effect of vancomycin is not altered by tranexamic acid, adrenalin, dexamethasone, or lidocaine in vitro

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christiane Schwerdt ◽  
Eric Röhner ◽  
Sabrina Böhle ◽  
Benjamin Jacob ◽  
Georg Matziolis
Keyword(s):  
Staphylococcus Aureus ◽  
Tranexamic Acid ◽  
Total Joint Arthroplasty ◽  
Staphylococcus Epidermidis ◽  
Joint Infection ◽  
Bactericidal Effect ◽  
Joint Arthroplasty ◽  
Zone Of Inhibition ◽  
Agar Diffusion Test

AbstractOne of the most challenging complications of total knee arthroplasty (TKA) is periprosthetic joint infection (PJI). There is growing evidence of a good anti-infective effect of intrawound vancomycin powder in total joint arthroplasty. At the same time, various different locally applied substances have become popular in total joint arthroplasty. The objective of this study was therefore to investigate a possible inhibition of the bactericidal effect of vancomycin by tranexamic acid, adrenalin, lidocaine, or dexamethasone. The bactericidal effect of vancomycin was quantified using the established method of the agar diffusion test. The plates were incubated with Staphylococcus aureus or Staphylococcus epidermidis and four wells were stamped out. The wells were filled with vancomycin alone, the tested substance alone or a mixture of the two. The fourth well remained empty as a control. The plates were incubated overnight at 37 °C and the zone of inhibition in each field was measured on the next day. All tests were run three times for each pathogen and mean values and standard deviations of the measurements were calculated. Differences between the substances were tested using the t-test at a level of significance of 0.05. The bacterial growth was homogeneous on all plates. The baseline value for the zone of inhibition of vancomycin was on average 6.2 ± 0.4 mm for Staphylococcus aureus and 12 ± 0.3 mm for Staphylococcus epidermidis. In all other substances, no inhibition was detected around the well. The combination of vancomycin and each other substance did not show any different result compared to vancomycin alone. The bactericidal effect of vancomycin on staphylococci is not altered by tranexamic acid, adrenalin, dexamethasone, or lidocaine in vitro.

scholarly journals Gentamycin-Loaded Bone Cement Released Time against Staphylococcus Aureus by using In Vitro Media as the Strategy for the Patient with Prostethic Joint Infection (PJI) after Hip and Knee Joint Arthroplasty

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0007
Author(s):  
Fajar Satria Pratama
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Release ◽  
Bone Cement ◽  
Joint Infection ◽  
Bactericidal Effect ◽  
Joint Arthroplasty ◽  
Release Time ◽  
Total Knee ◽  
Hip Arthroplasties

Introduction: Joint Arthroplasty is the best treatment modality to improves joint function, relieves pain, and increase the quality of life. There were about 0.5% to 0.8% of patients performed primary total knee and hip arthroplasties has been reported with Prostethic Joint Infection (PJI). Staphylococcus aureus is one of the most virulent bacteria which has identified in the isolation caused by PJI. There were increased number of primary arthroplasties. Gentamycin is an antibiotic which has a bactericidal effect for some gram positive and most aerobic and facultative anaerobic gram negative bacteria. They act by inhibiting protein synthesis. Method: This research is an experimental study.The object is Staphylococcus aureus which was treated by Gentamycin-loaded bone cement which were divided into 3 concentrations 5%,10%, and 20%. We have observed the antibacterial effect by measured how was the released time while we put it in agar plates. We controlled them every 2 weeks for observing the inhibition of ring assays which were formed. We were also calculated the diameter of ring assay. Result: Drug release profiles showed for 5%,10%,20% Gentamycin-loaded bone cement displayed a long enough drug release time about 14 weeks. The diameters of ring assay didn’t showed if they were affected by the released time. Discussion: We have been observed about Gentamycin-loaded bone cement released time with Staphylococcus aureus,we found if it can exist more than 14 weeks.There have been no study investigated about it before. In the present study by Gaoyang in 2018,they have been observed with vancomycinloaded bone cement,they had found if vancomisin loaded-bone cement provided sufficient effective antibacterial time at least 8 weeks. Conclusion: The Gentamycin-loaded bone cement released time against Staphylococcus aureus more than about 14 weeks.There is no different result between the length of released with ring assay diameters.

Tranexamic Acid Is Associated With Reduced Periprosthetic Joint Infection After Primary Total Joint Arthroplasty

2020 ◽  
Vol 35 (3) ◽  
pp. 840-844
Author(s):  
Hamidreza Yazdi ◽  
Mitchell R. Klement ◽  
Mohammed Hammad ◽  
Daisuke Inoue ◽  
Chi Xu ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Periprosthetic Joint Infection ◽  
Total Joint Arthroplasty ◽  
Joint Infection ◽  
Joint Arthroplasty

scholarly journals In Vitro Efficacy of Antibiotics Released from Calcium Sulfate Bone Void Filler Beads

Materials ◽  
2018 ◽  
Vol 11 (11) ◽  
pp. 2265 ◽  
Author(s):  
Phillip Laycock ◽  
John Cooper ◽  
Robert Howlin ◽  
Craig Delury ◽  
Sean Aiken ◽  
...  
Keyword(s):  
Staphylococcus Epidermidis ◽  
Calcium Sulfate ◽  
Joint Infection ◽  
Diffusion Method ◽  
Zone Of Inhibition ◽  
Disk Diffusion Method ◽  
Bone Void Filler ◽  
Biofilm Bacteria ◽  
Bone Void

15 different antibiotics were individually mixed with commercially available calcium sulfate bone void filler beads. The antibiotics were: amikacin, ceftriaxone, cefuroxime, ciprofloxacin, clindamycin, colistamethate sodium, daptomycin, gentamicin, imipenem/cilastatin, meropenem, nafcillin, rifampicin, teicoplanin, tobramycin and vancomycin. The efficacy of specific released antibiotics was validated by zone of inhibition (ZOI) testing using a modified Kirby–Bauer disk diffusion method against common periprosthetic joint infection pathogens. With a subset of experiments (daptomycin, rifampin, vancomycin alone and rifampin and vancomycin in combination), we investigated how release varied over 15 days using a repeated ZOI assay. We also tested the ability of these beads to kill biofilms formed by Staphylococcus epidermidis 35984, a prolific biofilm former. The results suggested that certain antibiotics could be combined and released from calcium sulfate with retained antibacterial efficacy. The daptomycin and rifampin plus vancomycin beads showed antimicrobial efficacy for the full 15 days of testing and vancomycin in combination with rifampin prevented resistant mutants. In the biofilm killing assay, all of the antibiotic combinations showed a significant reduction in biofilm bacteria after 24 h. The exposure time was an important factor in the amount of killing, and varied among the antibiotics.

scholarly journals Evaluation of Antimicrobial Activity of Different Herbal Products against Bacillus subtilis, Staphylococcus aureus, and Enterococcus faecalis Using Agar Diffusion Test: An In Vitro Study

2020 ◽  
Vol 8 (03) ◽  
pp. 109-114
Author(s):  
Rajinder Bansal ◽  
Manu Bansal ◽  
Nikhil Dev Wazir ◽  
Mandeep Singh Matta ◽  
Sanjeev Jain ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Bacillus Subtilis ◽  
Enterococcus Faecalis ◽  
Aloe Vera ◽  
Zone Of Inhibition ◽  
Diffusion Test ◽  
Herbal Products ◽  
Agar Diffusion ◽  
Agar Diffusion Test

Abstract Introduction The main aim of this study is in vitro evaluation of the antimicrobial efficacy of different herbal products, that is, propolis, garlic, neem, aloe vera, and rosemary, against Bacillus subtilis, Staphylococcus aureus, and Enterococcus faecalis using agar diffusion test. Materials and Methods In this study, total of 42 plates were prepared, 10 each of B. subtilis, S. aureus, and E. faecalis and 12 as test control (6 as positive and 6 as negative control). The effectiveness of five herbal products was ascertained by agar diffusion method against B. subtilis, S. aureus, and E. faecalis. Cultures of these test organisms were maintained on selective media slants in a test tube to collect sufficient number of microbial colonies for evaluation. The cultures were divided into three groups based upon microbes that were lawn cultured, respectively: In group A, 10 petri plates were having growth of B. subtilis; in group B, 10 petri plates were having growth of S. aureus; and in group C, 10 petri plates were having growth of E. faecalis. In all these 30 petri plates, five different herbal product discs were placed and these discs were designated as A (aloe vera), P (propolis), N (neem), R (rosemary), and G (garlic). Among remaining 12 petri plates, 4 petri plates were used as control (2 for positive and 2 for negative) for each of the bacteria. Results Propolis and rosemary showed maximum zone of inhibition against B. subtilis. Garlic, neem, and aloe vera showed maximum zone of inhibition against S. aureus. Conclusion All the herbal products showed zone of inhibition against S. aureus, B. subtilis, and E. faecalis.

scholarly journals Antibiotics in Bone Cements Used for Prosthesis Fixation: An Efficient Way to Prevent Staphylococcus aureus and Staphylococcus epidermidis Prosthetic Joint Infection

2021 ◽  
Vol 7 ◽  
Author(s):  
Andréa Cara ◽  
Mathilde Ballet ◽  
Claire Hemery ◽  
Tristan Ferry ◽  
Frédéric Laurent ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Epidermidis ◽  
Biofilm Formation ◽  
Joint Infection ◽  
Bone Cements ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Prosthesis Fixation

Prosthetic joint infections (PJIs) are one of the most frequent reasons for arthroplasty revision. These infections are mostly associated with the formation of biofilm, notably by staphylococci, such as Staphylococcus aureus and Staphylococcus epidermidis. To minimize the rates of PJIs following primary or revision total joint arthroplasty, antibiotic-loaded bone cements (ALBCs) can be used for prosthesis fixation. However, its use is still debated. Indeed, various studies reported opposite results. In this context, we aimed to compare the prophylactic anti-biofilm activity of ALBCs loaded with two antibiotics with ALBC loaded with only one antibiotic. We compared commercial ready-to-use cements containing gentamicin alone, gentamicin plus vancomycin, and gentamicin plus clindamycin to plain cement (no antibiotic), investigating staphylococcal biofilm formation for 10 strains of S. aureus and S. epidermidis with specific resistance to gentamicin, vancomycin, or clindamycin. Firstly, we performed disk diffusion assays with the elution solutions. We reported that only the cement containing gentamicin and clindamycin was able to inhibit bacterial growth at Day 9, whereas cements with gentamicin only or gentamicin and vancomycin lost their antibacterial activity at Day 3. Then, we observed that all the tested ALBCs can inhibit biofilm formation by methicillin-susceptible staphylococci without other antibiotic resistance ability. Similar results were observed when we tested vancomycin-resistant or clindamycin-resistant staphylococci, with some strain-dependent significant increase of efficacy for the two antibiotic ALBCs when compared with gentamicin-loaded cement. However, adding vancomycin or clindamycin to gentamicin allows a better inhibition of biofilm formation when gentamicin-resistant strains were used. Our in vitro results suggest that using commercially available bone cements loaded with gentamicin plus vancomycin or clindamycin for prosthesis fixation can help in preventing staphylococcal PJIs following primary arthroplasties, non-septic revisions or septic revisions, especially to prevent PJIs caused by gentamicin-resistant staphylococci.

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

Relative efficacy of tranexamic acid and preoperative anemia treatment for reducing transfusions in total joint arthroplasty

Transfusion ◽  
2016 ◽  
Vol 57 (3) ◽  
pp. 622-629 ◽  
Author(s):  
Joseph F. Styron ◽  
Alison K. Klika ◽  
Caleb R. Szubski ◽  
Deborah Tolich ◽  
Wael K. Barsoum ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty ◽  
Relative Efficacy ◽  
Preoperative Anemia ◽  
Anemia Treatment

scholarly journals Anaerobic Conditions Induce Expression of Polysaccharide Intercellular Adhesin in Staphylococcus aureus and Staphylococcus epidermidis

2001 ◽  
Vol 69 (6) ◽  
pp. 4079-4085 ◽  
Author(s):  
Sarah E. Cramton ◽  
Martina Ulrich ◽  
Friedrich Götz ◽  
Gerd Döring
Keyword(s):  
Staphylococcus Aureus ◽  
Staphylococcus Epidermidis ◽  
Biofilm Formation ◽  
Extracellular Polysaccharide ◽  
Growth Conditions ◽  
Anaerobic Conditions ◽  
Anaerobic Environment ◽  
Specific Mrna

ABSTRACT Products of the intercellular adhesion (ica) operon in Staphylococcus aureus and Staphylococcus epidermidis synthesize a linear β-1,6-linked glucosaminylglycan. This extracellular polysaccharide mediates bacterial cell-cell adhesion and is required for biofilm formation, which is thought to increase the virulence of both pathogens in association with prosthetic biomedical implants. The environmental signal(s) that triggers ica gene product and polysaccharide expression is unknown. Here we demonstrate that anaerobic in vitro growth conditions lead to increased polysaccharide expression in both S. aureus and S. epidermidis, although the regulation is less stringent inS. epidermidis. Anaerobiosis also dramatically stimulates ica-specific mRNA expression inica- and polysaccharide-positive strains of both S. aureus and S. epidermidis.These data suggest a mechanism whereby ica gene expression and polysaccharide production may act as a virulence factor in an anaerobic environment in vivo.

scholarly journals 7 Management of Periprosthetic Joint Infection

2021 ◽  
Keyword(s):  
Decision Making ◽  
Periprosthetic Joint Infection ◽  
Total Joint Arthroplasty ◽  
Joint Infection ◽  
Joint Arthroplasty ◽  
Orthopaedic Surgeon ◽  
Systemic Complications ◽  
Surgical Decision ◽  
Surgical Options ◽  
Surgical Decision Making

Periprosthetic joint infection (PJI) continues to be a devastating problem in the field of total joint arthroplasty. There are a number of surgical options to decide from and management decisions are based upon the interplay between host, pathogen, and surgeon characteristics. The goal of management is to maximize function, prevent systemic complications, and eradicate infection. Throughout this chapter we will discuss the most relevant recent literature and guiding theories to assist the treating orthopaedic surgeon in the surgical decision-making process.

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